Strategy Recommendations for Population Screening of Sickle Cell Hemoglobin in Low Resource Setting

Hemoglobin S (Hb S) is genetically inherited variant of hemoglobin affecting around 300 000 infants are born annually. Facilitates for universal population testing of carrier state are available only in developed countries. The screening tests for Hb S have their respective limitations and the confirmatory tests are costly and require experts for conduct and interpretation. The use of two tests will enhance the overall diagnostic accuracy at the level of screening. We have considered two scenarios for population screening for SCD – community based in health camp mode / house to house survey and facility-based mode at health center. The combination of lateral flow immunoassay based POCT with sickling test can be used in absence of HPLC for population screening. However, for antenatal women portable microelectrophoresis based test is recommended as it flags the presence other hemoglobin variants along with Hb S.